Thursday, 26 July 2012

The NHS Partners
Network formed in 2005 to provide a voice for private health companies, and was
initially made up of organisations involved in the government’s Independent
Sector Treatment Sector programme (ISTC). The ISTC initiative was to open up
non-emergency treatments to the private sector that would operate (no joke
intended) from treatment centres based within NHS hospitals.

When a leaked
document from the Health care Commission raised questions over the quality
standards within the ISTCs, the NHS Partners Network used its influence to make
sure a report on ISTC’s was less critical than otherwise would be.

In 2007, they
were voted on to the NHS confederation, the main representative organisation for
organisations offering NHS services.
Since the initial ISTC days, the Network has expanded to include
companies and organisations providing services to the NHS.

Social Investigations conducted Lords research

Why do they have influence?The NHS Partners Network is
largely made up of private healthcare companies, with a couple of non-profit
organisations thrown in. Their current members list contains 7 companies with financial
connections to MPs, Lords or former MPs.

Care UK: www.careuk.com
– Andrew Lansley John Nash the Chairman of Care UK gave
donations of £21,000 to run Lansley’s office when he was shadow health
minister. Bridgepoint
who have Lord Patten of Barnes on their books purchased Care UK.

Circle: www.circlehealth.co.uk
– Mark Simmonds MP is a strategic advisor - the self-styled “social enterprise” that became the
first private company to take over the management of an NHS hospital, is owned
by companies and investment funds registered in the British Virgin Islands, Jersey
and the Cayman Islands. See
Corporatewatch ‘An unhealthy business’

The full list of members is
below.

How have they used their influence?

When you have
connections like they have it certainly provides a platform to being able to
obtain high-level meetings.

According to
their 2007/08 annual report, they held ‘Major high-level’ meetings with

Andy
Burnham the Minister of State for Health.

Mark
Britnell, who was then the Director-General of Commissioning and System
Management for the Department of Health. Mr Britnell has since moved to the
private sector as Global Head of Health for business service giant KPMG, He
famously said in 2010, while discussing reforms to a private healthcare
conference: “In future, The NHS will be a state insurance provider not a state
deliverer”, and that “The NHS will be shown no mercy and the best time to take
advantage of this will be in the next couple of years'.

Mark
Simmonds as Conservative junior minister for Health Spokesman

The latter raises
some serious questions as to what part of the draft bill was influenced by the
network. In addition to this according to their 2007/08 Annual Report, in October 2007, they held 'informal conversations with Andrew Lansley' and the Conservative party conference, and perhaps more importantly, held a 'meeting with Lansley on the Conservative party's draft bill.'The latter suggests that they had advanced warning of the bill and parts of its content which they may have influenced. When we consider who their members are (listed below) this might be considered to be giving them an unfair advantage and certainly more notice that the public were given.What was said? Did they put in anything to do with competition? Lansley had competition in mind when writing the White Paper, he just didn't bother telling the public who he is meant to represent.

Health and Social Care bill

In 2008 they had
a Meeting with then shadow health secretary, Andrew Lansley, on matters to do
with the Conservative party’s draft bill.

In October 2010, Simon Burns (the Minister for Health), Earl Howe, and
Andrew Lansley’s Special Advisor, Bill Morgan, attended two meetings with David
Worskett, the director of the NHS Partners Network. In the meetings, the
ministers reassured the lobby director that opposition to parts of the bill
increasing competition would soon ‘dissipate’.

A further meeting head with Earl Howe and Simon Burns
on the 19th May, 2011, went well. Earl Howe offered a ‘depiction’ of
the ‘Government position’, that meant ‘“choice” was a non-negotiable.’ This
view led Mr Worskett to say: ‘He could have been delivering a précis of our
briefing notes (which of course he had already seen)’. No wonder then that
later in the day at a National Stakeholder Forum, Earl Howe ‘endorsed [Mr
Worskett’s] arguments twice during the session on competition and regulation’.

Competition in the bill

A newly discovered document has revealed the lobby
group held a ‘lengthy’ discussion with the chair of choice and competition of
the NHS Future Forum Sir Stephen Bubb, during the Health bill ‘pause’.

In the meeting according to the document which was
intended for the eyes of the Network’s members only, Mr Worskett had ‘agreed on the approach he (Mr Bubb) would
take, what the key issues are, and how to handle the politics.’ He has, he
concluded, ‘not deviated from this for a moment throughout the period.’ Perhaps
it is this influence that they are referring to in the annual summary 2010/11
report where they say, one of their ‘main activities’ involved ‘influencing the
development of the NHS reforms’.

The NHS Partners Network are not finished lobbying
yet, having recently responded to the first stage of the health regulator’s
(Monitor’s) review into the fair playing field for NHS providers. They held a
meeting under the auspices of the right-wing think tank "Reform" with
David Bennett, the head of Monitor who are running the review. The room was
full of ‘like-minded’ people. The NHSPN’s press release announcing their
submission to the review states: ‘We look forward to working with Monitor
throughout the consultation process.’

Assura Medical Limited : www.assuramedical.co.uk - Baroness Morgan of Huyton Ex-director of failed care home, Southern Cross, is a member of the advisory committee board of Virgin Group Holdings Ltd. Virgin Healthcare Holdings is a subsidiary of them, who took over Assura Medical Limited and renamed them Virgin Care. Vivienne Mcvey
is a board
member/Director of Virgin Healthcare holdings and has represented NHS Partners Network when giving evidence on behalf of the Care Quality Commission (CQC). Ms McVey is a member of the CQC Providers Advisory Group and was a part of the NHS future forum and is also a member of an 'Independent' Panel set up by Lansley in March to look at the impact of the NHS
Constitution.Barchester Healthcare: www.barchester.com
– Baroness Ford – Chairman - Chairman of Grove Ltd, a holding company for for
Barchester Health. Mike Parsons the Chief Executive was voted 2nd
most influential person in healthcare by the HealthInvestor members.

Bupa Home Healthcare: www.bupa.co.uk/home-healthcare
– Baroness Bottomley is a director, Lord Edmiston has shares, Lord Leitch is a
non-executive director, Baroness Liddell is an Associate member

Care UK: www.careuk.com
– John (now Lord) Nash the then Chairman of Care UK gave donations of £21,000 to run Lansley’s
office when he was shadow health minister. Bridgepoint who have Lord Patten of
Barnes on their books purchased Care UK.

Friday, 20 July 2012

A newly discovered document
has revealed a top-level political trio, held a secret meeting with a private healthcare
lobby group to reassure them about the likely calming of opposition to the
healthcare reform, two months before the bill was even introduced to
parliament.

In October 2010, Simon
Burns (the Minister for Health), Earl Howe, and Andrew Lansley’s Special
Advisor, Bill Morgan, attended two meetings with a private healthcare lobby
group, NHS Partners Network (NHSPN). These meetings have just come to light,
following the discovery of another document written by the NHSPN, which
revealed the discussions took place three months before the Health and Social
Care bill was introduced to parliament.

The purpose of the
discussion, according to the document, was to give members an opportunity to
‘express their support for the Government’s policy of Any Willing Provider
(explained below) and moves towards greater patient choice.’

In addition, the members
could express any ‘concerns about whether a level playing field would truly be
created’.

So, the NHS Partners
Network were able to access the very top of our political tree before our
elected politicians had even been given a chance to debate the bill in the
Commons. And no minutes were taken.

The meeting informed the
network of a ‘command paper’ that was about to be published by the Department
of Health, to set out the ‘principles of the NHS reforms more clearly’. They
also ‘received assurances’ that the Government will make it clear to
commissioners what the Any Willing Provider (AWP) policy means for them, and
that they intend to ‘adhere’ to the reform timetable.

The update on where the
government was in terms of action was backed up with further assurance that
opposition to the AWP policy would not last long. The introductory paragraph of
the document highlighted that both ministers and Mr Morgan expressed the view
that any problems with the implementation of the AWP policy, such as opposition
to commissioning of the independent sector from GP commissioners – were likely
to be ‘short-term’ and ‘dissipate’ in the future.

However, several months
after the meetings the situation had changed, because once the content of the
white paper had been realised, a near total rejection from both the public and
the medical profession resulted in the government taking a ‘pause’.

The so-called ‘listening
exercise’ required a temporary group to be set up, called the NHS Future Forum
which had Sir Stephen Bubb,
a David Cameron appointment, in charge of competition and choice. We now know
that Sir Bubb worked with the NHSPN, who together influenced the direction of
discussion. The newly established forum meant a new set of lobbying was
required, and the NHSPN made sure they were at the helm, as revealed in their
annual 2010/11 summary report:

‘This (pause) prompted a
major new effort to communicate our views to the NHS Future Forum, and to the
top-level political decision-makers to whom the forum will report.’

Part of the concerns the
lobby firm had now centred on the policy of ‘Any Willing Provider’ (AWP), which
had changed to ‘Any Qualified Provider (AQP). It was a semantic difference that
was hailed by the Liberal Democrats as a victory. In reality the AWP
commissioning procedure is set by an EU procurement directive, and the term
‘AQP’ does not exist in EU law.

The British Medical Journal
highlighted the significance of this change in an editorial
aimed at the media, who at the time had failed to pick up on it: ‘If a future
government wishes to bring a health or social care service back into public
sector provision (say if the consequences of this reform turn out to be bad for
patients) any existing or would-be provider may sue under EU law on
anticompetitive practices.’

The NHSPN, however, did not
want to take chances over any weakening of competition in the bill, and having
‘agreed on the approach’ to take with Mr Bubb in a previous ‘lengthy’ meeting,
they turned their attention to Earl Howe, who would be leading the debate in
the House of Lords.

On the 19th of May 2011, David
Worskett, the director of NHSPN, set up another meeting with the Earl. A newly
discovered document for the NHSPN’s members revealed that ‘Simon Burns also
asked to join the meeting’. Mr Burns’ request to be included, according to Mr
Worskett, indicated the recognition by the minister that NHSPN were ‘less than
happy about things.’

The meeting went well for
the lobbyists. The document revealed that although the ministers were
‘necessarily constrained’ by the fact that everyone was supposed to be
listening, they gave ‘every signal possible that they understood and
sympathised with our concerns and shared our view of the key issues and
priorities.’

Indeed this understanding
was absolute. Earl Howe offered a ‘depiction’ of the ‘Government position’,
that meant ‘“choice” was a non-negotiable.’ This view led Mr Worskett to say:
‘He could have been delivering a précis of our briefing notes (which of course
he had already seen)’. No wonder then that later in the day at a National
Stakeholder Forum, Earl Howe ‘endorsed [Mr Worskett’s] arguments twice during
the session on competition and regulation’.

The NHS Partners Network
are not finished lobbying yet, having recently responded to the first stage of
the health regulator’s (Monitor’s) review into the fair playing field for NHS
providers. They held a meeting under the auspices of the right-wing think tank
"Reform" with David Bennett, the head of Monitor who are running the
review. A fair playing field has nothing to do with it. If that were the case,
then Simon Burns et al would not have offered a reassurance on policy ahead of
a debate in the Commons. The NHSPN’s press release announcing their submission
to the review states: ‘We look forward to working with Monitor throughout the
consultation process.’

I bet they do.

Unanswered questions

So why were the trio of
Simon Burns, Earl Howe and Andrew Lansley’s special advisor, Bill Morgan,
holding a meeting to reassure a trade and lobby group, before our elected MPs
had even had a chance to debate the bill in the Commons?

Did Bill Morgan pass a
message back to Andrew Lansley or did Andrew Lansley pass a message onto NHS
Partners Network?

Further notes:

The newly appointed special
advisor to Andrew Lansley, Bill Morgan. The former private healthcare lobbyist
came under the spotlight in March 2011, following an investigation by
transparency campaigners Spinwatch.
Mr Morgan had received a list of GPs who were in favour of the reforms, who
would represent a ‘public relations coup.’ The list was provided by an
outsourcing firm called Tribal, who according to Spinwatch, had ‘£150 million
worth of government contracts’, and were connected to some of the new GP
Pathfinder Consortia.

Tuesday, 17 July 2012

This newly discovered document handed to Social Investigations reveals the true lobbying
that took place during the Health and social Care bill ‘pause’. I have edited some of the juicy
sentences – to view the full document details click here.

To view article: ‘Key Member of NHS Future
Forum Colluded with Lobby Group over Competition’, click here.Please share this far and wide.

To receive the original document email me on: andrewfiskar(at)gmail.com - and if you use the contents of this document, I would appreciate it if you quote Social Investigations as the source.

The task

‘Therefore
the tactical imperative had to be to influence the forum members directly and
to concentrate other activity on those who themselves would have most influence
on the forum.’

Stephen Bubb Chair of competition and Choice on NHS
Future Forum

‘ I also have
the impression that the arguments in favour of choice, competition, plurality
and economic regulation put forward by the small handful of like-minded members
ably led by Sir Stephen Bubb have often carried the day and won more support
than we might have expected.’

‘I had one
lengthy, very early discussion with Sir Stephen Bubb at which we agreed on the
approach he would take, what the key issues are, and how to handle the
politics. He has not deviated from this for a moment throughout the period.’

‘A number of
members secured individual meetings with him, thus reinforcing and validating
the messages. ‘

‘I had a second lengthy meeting with Stephen to discuss the position with him
last week, under the auspices of "Reform", with only a handful of
other (all like-minded) people present, including David Bennett, the chair of
Monitor. He has also consistently taken the same line as us throughout.’

No10
‘Several members have used their own "routes" to gain access to key
players within No.10 and have been able to report back that the stance there is
supportive’

‘I did brief the new No.10 health policy adviser very fully, and indeed
"cleared" our materials with him. I have has several other
"stock-take" phone conversations with him. We are certainly on
No.10's radar.’

‘We need to
keep as close as possible to No.10 over the next few weeks. So much depends,
first, on what the Forum Report actually says.’

‘I received an
invitation to the PM's big speech last Monday and went. (Incidentally, for
those who had the pre-event text, he specifically added a sentence about the
importance of patients being able to attend private hospitals if they wanted to.’

The Lib Dems
‘There have been a number of contacts with the Lib Dems. I had an early meeting
with Norman Lamb who continues to advise Nick Clegg very closely, and a further
very long phone call with him on Tuesday this week.’

‘Meanwhile Nick
Clegg is, frankly making noise in order to persuade parts of his party that he
is really driving the changes needed to "save the NHS".’

Health minister Simon Burns

‘Jill Watts and
I went to the DH yesterday to see Earl Howe. Unplanned, Simon Burns also asked
to join the meeting.’

Lords

‘Earl Howe's
depiction of the Government position was, to paraphrase, that
"choice" was a non-negotiable; real choice requires a range of
provider types; that means competition; and competition has to be expertly
regulated. He could have been delivering a précis of our briefing notes (which of
course he had already seen).’

‘Later in the day, at the National Stakeholder Forum, Earl Howe endorsed my
arguments twice during the session on competition and regulation .’

‘But as we move
into the next phase we will need to shift our efforts onto the politicians -
those the Government listen to, and those who will play key roles in the House
of Lords when the Bill gets there.’

BMJ

‘My analysis is
that the aim is to use the authority of the Forum's report and the listening
exercise to improve and make more acceptable the policy; circumvent the
traditional "health politics" of the BMA etc; and provide the
coalition with a robust basis for getting a revised Bill through the Lords and
past the remaining dissenting Lib Dems.’

Monitor

‘I currently
think the need for an economic regulator in the form of Monitor will be
endorsed by the Forum and retained in the Bill. The language may change:
"sector regulator" perhaps.’

‘What will
undoubtedly change are the top-level duties of the regulator. The hugely
contentious duty to promote competition will be dropped and instead we will see
duties to promote any or all of: "choice"; "integration of
care""; "provider sustainability"; "continuity of
services". That will be claimed by others as a huge victory.‘

‘If this view
is right, Monitor will be free to do its job, and while progress will not be
fast, the framework and principles will be alright for us.’

Media

‘We have also
had good coverage on the BBC website.’

‘And the whole sequence of Telegraph articles and
editorials on the importance of the Government not going soft on public service reform,
including some strong pieces on health, is something I have been orchestrating.’

This document,
which was handed to Social Investigations, reveals the lobbying process that
took place from the NHS Partner Network – in its attempts to ensure competition
remained a big part of the Health and Social Bill following the listening exercise.

No words have
changed as the details speak for themselves. To receive full original document contact me - andrewfiskar(at)gmail.com and if you write an article on the issues with this document, I ask you to please quote Social Investigations as your source.

At our AGM on
19 April we agreed on how best to handle the considerable threats posed for the
sector by the "pause" in the legislative process because of the
opposition to the NHS reforms and the return to levels of hostility towards the
independent sector not seen or heard for some years. The essence of the
strategy was to recognise that if the report by the NHS Future Forum to the
Prime Minister went the wrong way for us, retrieving the position would be
almost impossible. Therefore the tactical imperative had to be to influence the
forum members directly and to concentrate other activity on those who themselves
would have most influence on the forum.

Where has
the process got to?

To all intents
and purposes, the "pause for listening" is now over and the decision
taking phase is starting. The Prime Minister meets the Forum today for a final
"round-up" and the report will be drafted and agreed very early next
week. the Forum has talked to over 5000 people, with an overwhelming emphasis
on the mainstream NHS and especially clinicians.

From the
various sessions I have attended I would say that the quality of the discussion
has been higher and more balanced than I had feared would be the case. I also
have the impression that the arguments in favour of choice, competition,
plurality and economic regulation put forward by the small handful of
like-minded members ably led by Sir Stephen Bubb have often carried the day and
won more support than we might have expected. Support, that is, for the intent
and the substance, rather than for the presentation and mode of delivery, where
criticism has been sharp.

What have we
managed to do?

Our main thrust
was originally to try to use individual relationships with forum members to get
messages across, using "common hymn sheets" on our key issues.
However, on investigation it became clear that the number of personal contacts
were too few for this to be enough. We therefore sent more polished versions of
our key briefs to all forum members. I received about a dozen acknowledgements,
including several that specifically commended the clarity and helpfulness of
the briefs. That I hadn't expected but suggests the materials
"worked" in communications terms.

In terms of direct discussions:

•
I had one lengthy, very early discussion with Sir Stephen Bubb at which we
agreed on the approach he would take, what the key issues are, and how to
handle the politics. He has not deviated from this for a moment throughout the
period.

•
A number of members secured individual meetings with him, thus reinforcing and
validating the messages.

•
I had a second lengthy meeting with Stephen to discuss the position with him
last week, under the auspices of "Reform", with only a handful of
other (all like-minded) people present, including David Bennett, the chair of
Monitor. He has also consistently taken the same line as us throughout.

•
I have heard from most of the members who said they could make direct contact
with Forum members confirming they have done so. Thank you.

•
Personally I have been able to speak to Steve Field himself , Jimmy Steele ,
Niti Pall, Julie Moore, and Paul Farmer.

• I also
participated actively in two of the Forum's major "listening" events:
one run by the Confederation and one by/for the Secretary of State's National
Stakeholder Forum. Both were well attended by forum members. At the latter,
every Minister was present and I was able to make key points in a workshop
session attended by the Secretary of State and Earl Howe and chaired by Steve
Field.

Sir Stephen had
hoped to find a couple of hours for a meeting with the NHSPN Board, but the
schedule of country-wide meetings arranged for the Forum by the DH in the end
made that impossible. He is now hoping to be able to confirm a meeting on1 June
when he will discuss with us what his report says and what he thinks it mean
for all independent providers. I will confirm this to members as soon as I can.

In terms of
"supporting" discussions:

• I have
coordinated our position carefully with Monitor, the CBI and the FTN and have
devoted considerable time to securing a reasonably helpful response from the
NHS Confederation. That has, however, only gone off today, illustrating the
problems of trying to react speedily when representing disparate interests.

• Several
members have used their own "routes" to gain access to key players
within No.10 and have been able to report back that the stance there is
supportive, though there is low awareness of exactly what the independent
sector does or could do . I did brief the new No.10 health policy adviser very
fully, and indeed "cleared" our materials with him. I have has several
other "stock-take" phone conversations with him. We are certainly on
No.10's radar - I received an invitation to the PM's big speech last Monday and
went. (Incidentally, for those who had the pre-event text, he specifically
added a sentence about the importance of patients being able to attend private
hospitals if they wanted to, provided NHS standards and prices were being met.)

• There have
been a number of contacts with the Lib Dems. I had an early meeting with Norman
Lamb who continues to advise Nick Clegg very closely, and a further very long
phone call with him on Tuesday this week. I will come to the politics shortly.

• We organised
a letter from our Clinical Forum, on behalf of the 45,000 clinicians who do NHS
work from the independent sector, to Steve Field. This was powerful. Steve
himself told me how useful and well-argued it was and No.10 also thanked me for
it.

The DH

•
Jill Watts and I went to the DH yesterday to see Earl Howe. Unplanned, Simon
Burns also asked to join the meeting, which certainly indicates that they
recognise that we are less than happy about things. the two Ministers
(supported by Bob Ricketts) were necessarily constrained by the fact that
everyone is supposed to be "listening", but gave every signal
possible that they understood and sympathised with our concerns and shared our
view of the key issues and priorities. Earl Howe's depiction of the Government
position was, to paraphrase, that "choice" was a non-negotiable; real
choice requires a range of provider types; that means competition; and
competition has to be expertly regulated. He could have been delivering a
précis of our briefing notes (which of course he had already seen). Simon Burns
seemed more engaged than before, defended the reforms firmly and took notice of
our arguments on the issue of health sector training arrangements. In short, I
do not think, under the circumstances, we could have hoped for more from the
two ministers at this delicate moment in the process.

• Later in the
day, at the National Stakeholder Forum, Earl Howe endorsed my arguments twice
during the session on competition and regulation .

The Politics

What both
Ministers were at pains to point out is the need to try to distinguish between
three things: the policy debate; the health politics (BMA etc); and the high
level "noise" around the coalition politics. We said we completely
grasped this, but had to be hugely vigilant over the risk of the
"noise" turning into "real risk". They did not deny this.

However,
without wasting members' time on extensive political speculation, my analysis
is that the aim is to use the authority of the Forum's report and the listening
exercise to improve and make more acceptable the policy; circumvent the
traditional "health politics" of the BMA etc; and provide the
coalition with a robust basis for getting a revised Bill through the Lords and
past the remaining dissenting Lib Dems. Meanwhile Nick Clegg is, frankly making
noise in order to persuade parts of his party that he is really driving the
changes needed to "save the NHS". There will be more of that as we
enter the next phase, but we need to see it in context and not over-react.

The Forum's
Report

Again, beware
speculation, and we should know for sure in about a week, either officially or
otherwise, but I currently expect:

• Major changes
on "commissioning", which will become "clinically led
commissioning" rather than "GP commissioning. There will be more
flexibility on timetable and there will be a number ( 50 or so) of ongoing
commissioning bodies at the level of the current "clusters". These
will do the heavy lifting until "consortia" are up to the job; will
provide the location for commissioning which requires scale; will also provide
the place where clinical input from people other than GPs can be increased; and
where other vital skills can be accessed.

If that or
something like it emerges it should be better for us - terms of stability and
"expert planning and buying", than the original proposals.

• Major changes
on accountability, to reflect Lib Dem concerns to advance local democracy and
everyone's concerns about accountability for £60m+ of public funds. On to watch
for is Sir Stephen's idea of picking the concept of local "right to
challenge" which feature in the Localism Bill.

Of less direct
relevance to us, so impact relative to the original reform proposals is
probably neutral .

• The Education
and Training proposals will be endorsed in principle but slowed down: there is
no need for a crash programme of change so why try to do it at the same time as
everything else.

Impact is
helpful as it slowing down avoids the distraction and gives time for fuller
discussion of exactly how the independent sector participates.

• Economic
Regulation and competition - the big one for us. I currently think the need for
an economic regulator in the form of Monitor will be endorsed by the Forum and
retained in the Bill. The language may change: "sector regulator"
perhaps.

• What will
undoubtedly change are the top-level duties of the regulator. The hugely
contentious duty to promote competition will be dropped and instead we will see
duties to promote any or all of: "choice"; "integration of
care""; "provider sustainability"; "continuity of
services". That will be claimed by others as a huge victory.

• However, in
reality, those objectives are more akin to the ones required of other
regulators. Competition is indeed a means to an end, not an end in itself, and
can be used effectively to help achieve all of those objectives. And despite
Mr. Clegg's unusual "take" on European law, national government's
cannot change or undo EU law on "undertakings" or procurement!

Of course, this
is the area in which the forces of coalition politics are most in play and
there are other options which have been or are being talked about, including
retaining the CCP, and/or dropping Part 3 of the Bill. At this moment I do not
think these will emerge as the way forward but the next few days will determine
all.

If this view is
right, Monitor will be free to do its job, and while progress will not be fast,
the framework and principles will be alright for us.

The Media

Finally, the
media. We agreed we would "up" the profile on key issues, without
inflaming the debate. Members will have seen some very good reporting in the
specialist press of my public defence of the role of competition at a
conference earlier this week. We have also had good coverage on the BBC
website. Our Clinician's letter was mentioned in the Telegraph. And the whole
sequence of Telegraph articles and editorials on the importance of the
Government not going soft on public

service reform, including some strong pieces on health,
is something I have been orchestrating and working with Reform to bring about.

Next

We need to keep
as close as possible to No.10 over the next few weeks. So much depends, first,
on what the Forum Report actually says. But as we move into the next phase we
will need to shift our efforts onto the politicians - those the Government
listen to, and those who will play key roles in the House of Lords when the
Bill gets there. The report, which I am sure will be almost entirely accepted
by the Government, will then guide the redrafting of parts of the Bill so that
(Ministers hope) the legislative process can get under way again in early July.

The Head of a voluntary association who
was a key member of the Future NHS Forum during the government’s ‘pause’,
colluded with a private healthcare lobby group to agree a message, promoting
the benefits of competition in the Health and Social Care bill, a newly
discovered document has revealed.

When the government decided to take a
‘pause’ in response to the increasing resistance to the Health and Social Care
bill being rushed through parliament, the Department of Health set up the NHS
Future Forum to front the so-called ‘listening’ exercise. The participants in
the forum, were made up of individuals from across the NHS spectrum, without
private sector inclusion, however, a certain Sir Stephen Bubb, was appointed by David Cameron as
chair of the group on choice and competition.

Sir Stephen Bubb is head of the Association of Chief Executives of Voluntary
Organisations (ACEVO), which had been campaigning for a bigger role for the
voluntary sector in the public services, a key part of Conservative party’s
‘Big Society’, mantra. Mr Bubb, had according to the newly released book by
Nicholas Timmins ‘Never
Again?’ - been in touch with Andrew Lansley before the ‘pause’, to see
what could be done to promote the idea of ‘voluntary sector providers in the
reforms’

His appointment
according to the Timmins book, was requested by Health minister Simon Burns,
who asked him to ‘chair the competition work group.’ The eventual clearance for
his position came from No10, which was presumed to be David Cameron. His
appointment was canny, because the private sector were unable to get into the
forum as members and Mr Bubb’s role for increasing the voluntary sector’s
involvement in the ‘choice’ process, crossed over with the same desire’s of the
private sector. His
involvement as pro-competition spokesman did indeed go far beyond the voluntary
sector he represented. The newly discovered document handed to Social
investigations, reveals his collusion with the director of the trade and lobby
group, the NHS Partners Network, which took the
form of an agreed set of tactics.

The document
titled: NHS Partners' Network: Director's update on the NHS Reforms was produced on the 20th May 2011, just as
the ‘listening exercise’ was coming to a close. The document was written to bring together the various
lobbying processes that had taken place throughout the period and was meant for members eyes only. Under the
title ‘in terms of direct discussion’, David Worskett the director of the
network informs us of how, early on in the pause, he had one ‘lengthy’
discussion with Sir Stephen Bubb at which ‘we agreed on the approach he would
take, what the key issues are, and how to handle the politics.’ He has, he
concluded, ‘not deviated from this for a moment throughout the period.’ The
listening exercise it seems was fully underway.

This damning statement, confirms what
Mr Worskett said, as revealed in Mr Timmins book that ‘throughout the forums
deliberations, Bubb was “our only real route in”. He “fought valiantly to
ensure that an element of competition remained in the system”, resulting in
what David Worskett saw as a “pretty pro competition…and that was mostly,
though not entirely down to Steve Bubb.”

Indeed, not only did Mr Worskett get
through to Mr Bubb, but so too did other members of the network. According to
the second bullet point of direct discussions, ‘a number of members secured
individual meetings with him, thus reinforcing and validating the messages.’
Not content with this, a second ‘lengthy meeting took place in May 2011, a week
before the network document was written, which took place under the ‘auspices of "Reform"’, the right-wing think tank, according to the update. The discussion involved other ‘all
like-minded’ people and included ‘David Bennett’, the chair of Monitor, the
industry regulator, who he claimed had also ‘consistently taken ‘the same line
throughout.’ The connection to Reform is important. The deputy director of the right wing think tank, Nick Seddon is connected to an orchestration of the Telegraph's editorial by Mr Worksett, according to the document, promoting the benefits of competition. The story of the Telegraph's involvement is explored here...

Mr Bubb and Mr Seddon are both on very good terms, as
revealed in a post written by Sir Stephen Bubb on his blog
a week before the official launch of the NHS Future Forum on the 31st
of March 2011.

He gushes: ‘So a somewhat bleary eyed early morning start to
get to Canary Wharf for a big Reform conference on the Big Society. I was on
the opening panel, chaired by my favourite think tank leader, Nick Seddon.’ It wasn't always like this. Back in 2008, Mr Bubb was talking a very different tune about Mr Seddon writing: 'I see that Nick Seddon , the journalist who I chastised recently has been at it again...He apparently thinks that all the bosses of the top charities form a champagne quaffing elite whose views are only of "incidental interest " or even " objects of scorn"...I'm having lunch with Mr Seddon soon . But he gets no champagne...'

Stephen Bubb's ability to get the 'agreed' message across
was appreciated by Mr Worskett who concluded: ‘…the arguments in favour of choice, competition, plurality
and economic regulation put forward by the small handful of like-minded members
ably led by Sir Stephen Bubb have often carried the day and won more support
than we might have expected.’ By all accounts the lobby group have achieved what they said they had in their 2010/11 Annual Summary, which stated: 'Following the UK general election 2010, our main areas of activity have included: influencing the development of the NHS reforms.'

The NHS Partners Network have not finished there, having recently submitted
their paper in a review set up by Andrew Lansley to look into
whether healthcare providers are able to fully participate in providing NHS
services.

In their
submission, the partner network complained that local NHS organisations are
using ‘local or known organisations, rather than considering the
opportunity to develop new relationships’, and that the’ structure and decision
making systems are not inclusive of all providers on an equal basis.’

Heading the review
is David Bennett, who attended the ‘lengthy’ meeting of 'like-minded' people,
with Sir Stephen Bubb. Mr Bennett has previously and predominantly worked for
global consultancy company Mckinsey & Co as a director, and without any
previous experience in government, became the Chief policy Officer to Tony
Blair. McKinsey & Co, were responsible for many proposals drawn up in the
health and Social Care bill and despite leaving the company 8 years ago, his
communication with the company hasn’t stopped.

Researcher of Green Benches blog Dr Éoin Clarke, obtained letters between Mr Bennett and
Nicholaus Henke of McKinsey & Co, using the Freedom of Information Act. The
correspondence revealed a cosy discussion between McKinsey & Co and the
Department of Health (DoH) suggesting an informal meeting to discuss the
passage and implementation of the NHS bill. In addition, Mr Bennett felt it
perfectly acceptable to receive hospitality from McKinsey & Co in June
2011, just after the listening exercise had finished, where he flew
business class to New York, stayed at a five-star hotel and attended a lavish
banquet. Not very becoming of the head of a regulatory body of our NHS.

Naturally, the
government and their apparatchiks will dismiss any consideration of bias under
the marketing
speak of ‘promoting the ‘interests of patients’, and ‘choice.’ However, one
quote made by David Bennett in an interview with the Times and highlighted in
Nicholas Timmins book reveals just how bias the head of the
‘independent’ review will be. “We did it in gas, we did it in power, we did it
in telecoms. We’ve done it in rails; we’ve done it in water. So there is
actually 20 years experience of taking monopolistic markets and providers and
exposing them to economic regulation.”

Of course this
could read, there has been 20 years of handing over public resources into
private hands raising the cost of living for the consumer and increasing
subsidisation for the taxpayer, it just depends if you see the world through
ideologue or economic fact. Indeed Mr Bennett was involved in the process that
led to the decision process to set 49% of hospital income from private sources.
How can a man with such clear bias be the head of Monitor, and a review process
which will be making changes that will place private companies on an ‘equal’
footing with other NHS providers. The answer is it won’t, and his position as
head of Monitor is just another piece in the jigsaw of handing the NHS over to
private companies, one which Stephen Bubb has played a key role.

At least we can
be rest assured no decisions were agreed upon until the Forum's report was signed off.
Ah wait a minute!

On the the 7th
of June, Bubb wrote once more on his blog. This time revealing this
extraordinary revelation: ‘just as I was signing off our Panel's report on
" Delivering real choice" I get sent a copy of the PM speech
announcing he is accepting many of our key recommendations although we haven't actually given him
the report yet!)’ He continued: ‘I am unclear why he thought it was a good idea
to pre announce acceptance of much of our Report, but it is welcome.’

Do you think
Stephen Bubb and David Bennett resign?

Note to editors: The NHS Partners Network membership largely
consists of private healthcare companies, who are well connected to our
parliamentarians. Six of their members have direct financial links to MPs,
former MPs, and Lords providing a well-connected source to parliament. These
include Circle who have Conservative MP Mark Simmonds on their team as a
strategic advisor, who also acts as Vice Chair on the Associate Health Group. Care UK, whose Chairman John Nash donated £21,000 to run Andrew Lansley’s
office when he was shadow health secretary, and Barchester Health, who have
Baroness Ford as their chairman and Mike Parsons as their Chief Executive,
who was voted the 2nd most influential person in healthcare by the
influential healthcare magazine ‘HealthInvestor’ members in their top 'Power Fifty' awards.

Incidentally - Bubb wrote in Febraury 2012: 'Tesco have their premier cru on offer for half price. It's a great dry
champagne and at a very reasonable price , such that even a third sector
CEO could get one!' It seems Seddon was right first time around. No wonder they are are now friends.